Do the current topical medications for melasma treatment really help? I believe this is a question that many people will be concerned about, especially for some melasma patients who are not too willing to accept oral medication or laser treatment, and will place great expectations on topical medications. So today, we focus on sharing with you the topical medication in melasma treatment and how much it can really help.
First of all, when it comes to the drugs applied, the first choice of dermatologists is usually hydroquinone cream, not only because of the long history of hydroquinone in treating hyperpigmented skin diseases in humans (started in the United States in 1966), but more importantly because of the depigmentation effect that cannot be replaced by other topical drugs. Then let’s get to know this drug first: hydroquinone, also known as hydroquinone, acts on melasma mainly by inhibiting tyrosinase, an important enzyme that can lead to the formation of macula (mainly melanin), so that melanin formation is reduced and ring-breaking is increased, and it may directly inhibit the synthesis of DNA and RNA of melanin vesicles, so that The melanin in the epidermis becomes less and less and plays a light spot effect.
As one of the most widely used topical drugs for melasma treatment, is hydroquinone really effective?
The answer is positive, and many physicians at home and abroad have done research in this area, with concentrations ranging from 1.5% to 8% in large sample clinical control studies, and the general conclusion is that the higher the concentration, the better the efficacy, but the side effects also increase.
Scientific treatment of melasma is a long process, and topical medication is no exception. Generally, we recommend hydroquinone cream to be used for more than 4 weeks.
Side effects of using hydroquinone cream.
1. Skin irritation in the area of application: This is the most common, mostly occurring within 2 weeks of the first use, with an incidence of about 25% when using 4% hydroquinone cream. What should I do if this happens? In fact, most people only have mild skin redness, no need to stop using; but if there is also a more obvious itching, stinging or burning sensation, contact dermatitis may occur, at this time, you need to stop using immediately and see a dermatology clinic.
2, hypopigmentation or depigmentation: commonly speaking, it is “over-treatment”, which is not common nowadays, mainly because the concentration of hydroquinone we use is low, and the other is that once the excessive whitening of the skin (i.e. whiter than normal skin color) is found in the process of use, we should stop using it.
3, exogenous brown yellowness: this has been reported in some foreign countries (brown or black race), mainly because of high concentration; intraocular pigmentation and permanent corneal damage are also extremely rare, and can be completely avoided as long as you pay attention not to apply to the eyes when applying.
If I am allergic to hydroquinone, are there any other options?
Of course there are, we commonly use L-vitamin C, azelaic acid, glycyrrhetinic acid, arbutin, etc. These can not only improve pigmentation if combined with moisturizing creams, but also improve dry skin which is more helpful for melasma recovery.
In general, topical medications have a certain auxiliary role in the comprehensive treatment of melasma, and the combination of this application method can improve the effective degree of treatment of melasma or shorten the effective time of treatment, which is also one of the gospel for melasma patients.
We would like to share with you a few tips on application.
1. Hydroquinone is a photosensitive substance, two points should be noted.
One is preservation, make sure not to forget to screw on the lid after opening and using.
The second is the time of application, applied at night is necessary, if applied during the day can not be exposed to the sun, otherwise it will be ineffective or even a small number of people triggered photosensitivity, which is similar to L-vitamin C.
If you find that hydroquinone cream becomes yellow or even brown when you apply it, it is not recommended to use it because it has oxidized and deteriorated.
2, sensitive skin melasma patients are generally not recommended to use hydroquinone alone: if you must use it, you can try it for three days in the local area and expand the application area only when no symptoms such as redness, edema and abnormal sensation appear.
3.The usual order of skin care during daytime is recommended.
Full-face water (you can also skip this step)-local hydroquinone/levitamin C, etc.-full-face moisturizer or lotion-full-face sunscreen/local thickening-makeup (you can also skip this step).